December 2015

A global mission to spread clubfoot treatment, training to those in need

More than 50 years ago orthopedic surgeon Ignacio V. Ponseti, MD, developed a technique to correct congenital clubfoot. The Ponseti method corrects the deformity through the use of serial casts followed by application of a specialized brace, and is now the preferred method of treatment worldwide.

In 1995, Ponseti, professor of orthopaedics at University of Iowa in Iowa City, recruited John Mitchell, who had experience making anatomical foot models, to create clubfoot models. Mitchell’s interest in the procedure grew, and he decided to independently design a device to be a more comfortable and effective brace than the current models.

Mitchell had had no previous experience designing braces, but during his work creating clubfoot models he realized the braces patients were using were far from flawless.

“The babies had blisters and sores on their feet when they were only six months old,” he remembers. “I turned to Ponseti and I said, ‘Why don’t you call the company and have them fix the braces so they don’t hurt the babies?’ He said they wouldn’t, then asked, ‘Why don’t you do something about it?’”

So Mitchell did.

In 2003, he established MD Orthopaedics to manufacture and distribute the product. The company, located in Wayland, IA, is about 50 miles from the University of Iowa, which allowed Mitchell to maintain close contact with Ponseti during the brace’s development.

Mitchell spent two and a half years working in his garage to develop a brace, sending more than 25 prototypes to Ponseti to evaluate until the design was just right. The Mitchell brace features two ankle foot orthoses (AFOs) connected by an abduction bar, each with a rubber inner lining and soft synthetic leather body that adapt readily to the foot and contribute to patient comfort. Additionally, the AFOs are fastened with a patented Quick Clip model that snaps on and off of the bar and has viewing holes at the heel to allow the patient’s parents or caregiver to verify proper placement.

The improvements developed by Mitchell allow for increased compliance with the Ponseti method and help correct clubfoot more effectively.

Mitchell credits a meaningful conversation with God for his pursuit of a better brace and the formation of MD Orthopaedics.

“The thing that’s amazing to me is I think back now and I almost didn’t do it,” he said. “I had a good job and I had friends. And I heard the Lord tell me, ‘Leave this job and your friends. Come on, I have something else for you to do.’ It was scary. And I look back now and think, I was obedient, and I’ve changed so many people’s lives.”

In efforts to spread clubfoot care to the rest of the world, Mitchell and his wife, Jean Mitchell, founded On His Path, a nonprofit extension of MD Orthopaedics that supports international missions and donations. The program also provides for handicapped individuals, widows, orphans, and those in need of clean water and nutrition programs.

“I knew I wanted to help [children with] clubfoot and handicapped people and people who are [in the] third world and have issues like water [supply] and education,” Mitchell said. “So it’s kind of a broad scope. It covers a lot of things.”

Mission trips have included visits to India, El Salvador, and Haiti, among others, with volunteers including MD Orthopaedics staff and community members as well as area pastors and ministers, according to Emily Ferguson, business manager of MD Orthopaedics and executive director of On His Path.

“All our MD Orthopaedics employees volunteer hours of their personal time helping with On His Path projects,” Ferguson said. “Employees also perform all administrative and operational tasks for On His Path.”

This set-up ensures every dollar donated goes directly and fully to the project or program it’s meant for, she said.

The group supports clubfoot treatment and clinics around the globe. For example, On His Path and Ponseti International, an association that advocates for use of a method, helped coordinate the second annual Ponseti Method Training Course in El Salvador. About 39 orthopedic surgeons, physiotherapists, nurses, and residents underwent training. Since 2012, On His Path has identified and treated hundreds of patients in El Salvador. Through training of local physicians, they hope to continue reaching more patients with treatment, she said.

Mitchell is thankful for the risk he took and the results he’s influenced.

“Our product is made here in the US,” Mitchell said. “And I know it helps kids all over the world, and it’s neat that you can do that from a little town like ours in the middle of Iowa, which has less than a thousand people. It’s a little town, and we’re affecting the world. That’s neat.”